MEDICARE: MR. EVELIO CAMPOS UGARTE ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	ARNP9315782	FL

General Provider Information

NPI Number	:	1881067726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EVELIO CAMPOS UGARTE ARNP

Provider Business Mailing Address
First Line	:	18900 N TAMIAMI TRL STE 9
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-7307
Country	:	US
Telephone Number	:	239-567-1000
Fax Number	:	239-567-1008

Provider Business Practice Location Address
First Line	:	18900 N TAMIAMI TRL STE 9
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-7307
Country	:	US
Telephone Number	:	239-567-1000
Fax Number	:	239-567-1008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2015
Last Update Date	:	04/08/2026

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